Neuromuscular relaxants

Question 1

tubocurarine

Answer 1

nondepolarizing, competative, nicotinic receptor antagonist with the longest half life of the curare drugs
this drug is not used clinically
equal elimination from the kidney and liver

Question 2

pancuronium

Answer 2

nondepolarizing, competative, nicotinic receptor antagonist with a pretty long (over an hour) half life
primarily renal excretion
renal elimination

Question 3

vecuronium

Answer 3

nondepolarizing, competative, nicotinic receptor antagonist with an hour long half life
primarily renal elimination

Question 4

mivacurium

Answer 4

nondepolarizing, competative, nicotinic receptor antagonist with a very short half life
complete cholinesterase elimination

Question 5

rocuronium

Answer 5

nondepolarizing, competative, nicotinic receptor antagonist with an hour long half life
complete liver elimination

Question 6

clinical uses of non depolarizing, competitive, nicotinic receptor antagonists

Answer 6

surgical procedures (intubation, diaphragm relaxants during mechanical ventilation)

Question 7

side effects of non depolairzing, competitive, nicotinic receptor antagonists

Answer 7

apnea, non analgesic

Question 8

succinylcholine

Answer 8

depolarizing nicotinic receptor antagonist that results in prolonged depolarization of the muscle membrane

Question 9

characteristics of succinylcholine phase 1 block

Answer 9

depolarization of muscle membrane, which results in ~4-8 min of contraction
fluctuating between contraction and relaxation
flaccid paralysis
effect augmented by cholinesterase inhibitors

Question 10

characteristics of succinylcholine phase 2 block

Answer 10

exposure exceeds 30 min
unknown mechanism results in 0 excitability of the m membrane, despite repolarization
must wait for phase 1 effects to stop (succinylcholine leaves NMJ)
then give cholinesterase inhibitors, which will counteract phase 2 effect

Question 11

baclofen

Answer 11

GABAb agonist (which does what? where?) administered intrathecally (why?)

Question 12

benzodiazepines

Answer 12

positive acting GABAa agonist, functions in enhancing the activity of GABAs presynaptic inhibition

Question 13

tizanidine

Answer 13

alpha2 adrenergic agonist that inhibits both pre and post synaptic transmission of APs

Question 14

dantrolene

Answer 14

blocks Ca release from the SR by inhibiting RyR used in chronic m spasticity and malignant hyperthermia

Question 15

malignant hyperthermia

Answer 15

a genetic mutation in the RyR that leads to its overactivation